Michelle coordinates the volunteers providing complementary therapies such as aromatherapy massage or reflexology sessions to patients or carers at home in Bucks. Having started as a Clinical Nurse Specialist in Rennie Grove’s Hospice at Home service, Michelle explains how her career and skillset has progressed over the years and how important offering the Complementary Therapy (CT) service is.

“My role is to coordinate CT for patients and carers. We have a team of qualified therapists who visit patients and family members in their own homes on a voluntary basis. I make initial contact with the client then discuss with them which therapies would suit them best.

“By acting as a link between the nursing teams and volunteer therapists, I ensure they are kept informed of any changes to a patient’s or carer’s needs - as well as additional referrals. I’m fortunate to be able to combine my experience in nursing with my skills as a masseuse, offering aromatherapy treatments and massages. As a nurse therapist I can plan my visits with the nursing teams. I incorporate massage with symptom control and any nursing duties which may be needed at the time of visit. With patient referrals increasing, being able to offer both CT services and nursing care within the same role has been an effective way of working.

“Hospice care has developed in leaps and bounds in the last 10 - 20 years. It has needed to change to cope with increased demands on services due to patients living longer with cancer - but also widening support to people with other life-limiting illness such as heart and lung conditions. Patients may be having treatments to control symptoms and even with advanced diseases the nurse’s role has developed academically.I have embraced the changes: studying for a degree in palliative care and more recently qualifying as an independent prescriber. However, I feel strongly that CT still has a valuable role to play. On a personal level I have really enjoyed being able to incorporate massage in my work with patients and feel my symptom control skills are enhanced by it.

“CT provides a great opportunity to offer holistic care. It can be a valuable source of relaxation and can in turn help with physical and psychological care. For example, stiffness caused by immobility or tension can be eased and the side effects of treatments such as constipation and nausea can be reduced using reflexology and aromatherapy. It is particularly useful for patients who prefer a less medical approach to their care.

“I believe complementary therapy can provide different experiences for different people. For some it is purely a time that they can relax uninterrupted, for others it can be the privacy they need to explore and express their feelings without the fear of upsetting their loved one. For carers it can offer a valuable source of support to help them carry on providing care at home. Although carer support is very much part of the nursing role, some carers feel they should not use nursing time for their own benefit. With the CT services they do not feel guilty about taking some of that time for themselves.

“As well as being really valuable for patients and their primary carers, CT can be an important link with the nurses. Occasionally patients may not want nursing visits very often, either because they are feeling brighter, or because they don’t want to keep talking about their illness. This can be the case even when someone is approaching end of life. By maintaining a relationship with a patient through CT, we are able to bring in other services in a timely way to enable patients to stay at home if that is their wish.

“Some patients are understandably anxious and CT is an effective way of building a rapport and helping them to relax and feel more in control of their condition. CT can even reduce the need for nursing visits, for example: a reiki therapist provided great comfort to a lady feeling isolated and anxious about her deteriorating breathing. By helping to control the symptoms and improve her sense of wellbeing, the therapist’s input meant that the number of nursing visits could be reduced from almost daily to once a week.

“Our CT volunteers are absolutely crucial to what we can offer and I am always struck by how generous they are in giving their time. I have great respect for what they do. We offer support to the therapists and I meet with them in a group support session every 6-8 weeks. Our most popular channel of communication is via email or phone, and it is important that they know they are always able to contact me. One of the biggest challenges in managing the CT team is that you have to understand that the volunteers have busy lives and are not always available every week. Therefore there are times when it is hard to provide as much therapy as may be required.”

“With this is mind, I would love to see the team expand. We cover such a large area that having more therapists would mean that patients and carers would have more choice of treatments and appointments. For therapists, being part of a team provides a great source of support and learning; it is a good way to connect with other therapists and is very rewarding. We give comprehensive training for our volunteer roles, which is something I cannot stress enough. Even if therapists feel they can’t spare the time to become a volunteer Complementary Therapist, there may still be other ways that they can support us so we would encourage them to get in touch.”